We had a choice of agents such as sorafenib or sunitinib in the first-line setting, and strong consideration was given to interleukin-2. Now, we have a dozen choices for therapy, including VEGF-directed agents, mTOR inhibitors, and novel immunotherapeutic strategies. A big dilemma for the medical oncologist is picking and choosing the right regimen for the right patient.
The clinical challenges we have had in medical oncology for RCC management, as is the case in every genitourinary malignancy, permeate into the urology space as well. Just as the struggle to pick the optimal therapy for metastatic disease, we now have a choice between observation, VEGF-directed agents and immunotherapy trials in the adjuvant setting. Discussions around adjuvant therapy require complex discussions with both medical and surgical disciplines. Of course, just this year, the biggest news has centered around the issue of cytoreductive nephrectomy – a perfect example of the need for a multidisciplinary approach in this field.
On a regular basis, I will try to bring to you the latest developments in RCC research, and place it in a context that will help you with the day to day management of patients you are seeing in the clinic. Through live coverage of our most important meetings (ASCO, AUA, and ESMO), news on RCC will be delivered to you in real-time with perspectives offered not just by myself, but an array of clinical investigators. I invite your comments and feedback – we have a unique opportunity here to bring the latest research forward and discuss its merits with leaders in the field.
Written by: Sumanta Kumar Pal, MD